NPIMap

Organization Active NPI

Liberty Dialysis - Oklahoma City LLC

Doing business as Liberty Dialysis - Woodland Park

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mercer Island, WA
National Provider Identifier
1093984270
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
LIBERTY DIALYSIS - OKLAHOMA CITY LLC
Doing business as
Liberty Dialysis - Woodland Park
Practice address
7650 SE 27TH St
Suite 200
Mercer Island, WA 98040-3060
Phone
(206) 236-5001
NPI assigned
Feb 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ryan B Pardo
Title
Vice President
Phone
(206) 236-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

7650 SE 27TH St
Suite 200
Mercer Island, WA 98040-3060

Mailing address

7650 SE 27TH St
Suite 200
Mercer Island, WA 98040-3060
Phone (206) 236-5001

Other names 1

  • Liberty Dialysis - Woodland Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Liberty Dialysis - Mercy Dialysis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1093984270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SE 27TH ST",
            "address_2": "SUITE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403060",
            "telephone_number": "206-236-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 SE 27TH ST",
            "address_2": "SUITE 200",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403060",
            "telephone_number": "206-236-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - OKLAHOMA CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "206-236-5001"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Dialysis - Woodland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.